This protocol applies to patients presenting with renal colic where imaging demonstrates a kidney stone exceeding 10 mm in size, or where significant hydronephrosis (dilation of the renal pelvis) is identified. These findings place the patient outside the typical expectant management pathway.
Either a stone size larger than 10 mm or the presence of significant hydronephrosis indicates that standard conservative measures are insufficient, and an escalated, specialist-directed approach is required.
The protocol involves prompt pain relief using an anti-inflammatory analgesic, alongside a defined pathway for active stone removal — which specific steps follow, and when, is covered in full in the structured protocol below.
Kidney stone removal confirmed on imaging.
Referral to a urologist for active stone removal is warranted when the stone is larger than 10 mm or if significant hydronephrosis is present.
Nonsteroidal anti-inflammatory drugs (e.g., ketorolac, 30 to 60 mg intramuscularly) are more effective and have fewer adverse effects than opioids.
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